CALCULATION OF CHILD AND ADULT STANDARD LIVER VOLUME FOR LIVER-TRANSPLANTATION

Despite refinements in surgical techniques for liver transplantation, liver size disparity remains one of the most common problems in pediat ric patients. Optimal liver graft size remains unknown and the volume of diseased liver in the recipient is not indicative of the volume (st andard liver volume [LV]) optimal for the recipient's metabolic demand s. To establish a formula for calculating the standard LV in the pedia tric and adult populations for liver transplantation, whole LVs were m easured using computed tomography (CT) in 96 patients (65 pediatric an d 31 adolescent or adult subjects) with normal liver whose disease con ditions did not seem to affect body weight (BW) or LV. In the 96 subje cts, the ratio of estimated LV to BW decreased gradually as age increa sed until approximately 16 years, when it started to level off. On the other hand, there seemed to be a directly proportional relationship b etween the estimated LV in. vivo and body surface area (BSA) (r = .981 ; r(2) = .962; P < .0001) in the subjects as a whole, and the formula, LV (mL) = 706.2 x BSA (m(2)) + 2.4, was established from the measured data by simple regression analysis. Another predicting equation, LV ( mL) = 2.223 x BW (kg)(0.426) x body height (BH) (cm)(0.682), was produ ced by multiple regression analysis (r(2) = .969; P < .0001). Consider ing its simplicity of use, we adopted the first formula for predicting standard LV in an individual patient.